Green PANCE-Arrhythmias

Question 1

The clinical significance of an arrhythmia depends on….

Answer 1

1. how much it impairs cardiac output

2. how likely it is to worsen into a more severe condition

Question 2

Electrolyte abnormalities, hormonal imbalances, hypoxia, drug effects, and MI ischemia increase…

Answer 2

Susceptibility of arrhythmia

Question 3

Presentation can range from asymptomatic to hemodynamic instability, shock and death

Answer 3

Arrhythmia

Question 4

ECG monitoring, measurements of HR variability, signal averaged ECG, electrophysiologic testing and autonomic testing

Answer 4

Diagnostics for arrhythmias

Question 5

HR under 60bpm

Answer 5

sinus bradycardia

Question 6

When bradycardia causes symptoms, the rate is usually less than…

Answer 6

50 bpm

Question 7

Sinus bradycardia (HR

Answer 7

Well conditioned athletes

Question 8

If a pt is not a well conditioned athlete, sinus bradycardia (HR

Answer 8

Sinus node pathology, with increased risk of ectopic rhythms

Question 9

HR >100 bpm

Answer 9

sinus tachycardia

Question 10

…this occurs with fever, exercise, pain, emotion, shock, thyrotoxicosis, anemia, heart failure and use of many drugs

Answer 10

Sinus tachycardia (HR>100 bpm)

Question 11

Tachycardia normally does not cause clinically signifiant symptoms until the rate is…

Answer 11

> 150 bpm

Question 12

Atrial premature beats are usually a…

Answer 12

benign finding (requiring no treatment in the absence of symptoms)

Question 13

What do patients with Paroxysmal supra ventricular tachycardia typically complain of?

Answer 13

“Racing heart”

Question 14

Paroxysmal supraventricular tachycardia usually occurs in persons without…

Answer 14

structural

Question 15

What is the most common chronic arrhythmia

Answer 15

Atrial fibrillation

Question 16

Incidence and prevalence of A fib increase with…

Answer 16

Age

Question 17

This arrhythmia can lead to a significant decrease in cardiac output and is the most common cause of embolic cerebrovascular accidents

Answer 17

A fib

Question 18

This is called “holiday heart” when caused by excessive alcohol use or withdrawel

Answer 18

A fib

Question 19

This usually occurs in patients with COPD, heart failure, atrial septal defect or coronary artery disease

Answer 19

Atrial flutter

Question 20

________ rhythms occur in patients with normal hearts or those with myocarditis, CAD or digitalis toxicity

Answer 20

Junctional

Question 21

Patients may present with palpitations, angina, fatigue or other symptoms of heart failure

Answer 21

Arrhythmias

Question 22

Unstable arrhythmias are treated with..

Answer 22

Electricity

Question 23

Signs and symptoms of a(n) ________ arrhythmia include: chest pain, dyspnea, altered mental status and hypotension

Answer 23

Unstable

Question 24

Patients with unstable BRADYcardia leading to hypotension, shock, altered mental status angina, or heart failure should be treated with either:

Answer 24

A vagolytic (ie atropine) OR
Positive chronocotropic (ie epinephrine or dopamine)

Question 25

Patients with unstable TACHYcardia leading to hypotension, shock, altered mental status, angina or heart failure should be treated with..

Answer 25

Synchronized cardioversion

anti-arrhythmic therapy may also be indicated, i.e. Beta blocker, lidocaine

Question 26

A regular, narrow complex tachycardia usually represents…

Answer 26

AV nodal reentry tachycardia (ie PSVT)